This disclosure relates to compression bands, and more particularly to compression bands for use as a hemostatic device on a wrist of a patient.
Radial artery puncture is used to obtain blood samples or otherwise access a patient's artery, for example for obtaining an arterial blood sample for blood gas measurement or for heart catheterization via the radial artery, or other medical procedures. A needle is inserted into the patient's artery to obtain a blood sample. Once the sample is obtained, the needle is removed and pressure is applied to the puncture site for a sufficient period of time to ensure bleeding will not occur, typically for at least 5 minutes. The typical way to apply pressure is to have the phlebotomist press a gauze pad against the puncture site with the phlebotomist's thumb. This requires that the phlebotomist maintain the pressure for sufficient time, which requires the phlebotomist to remain applying consistent pressure during the entire time. It would be desirable to provide a way to apply the pressure in a controlled manner without requiring the phlebotomist to manually press against the puncture site for an extended period of time, freeing the phlebotomist to do other tasks and removing variability in the amount of pressure provided and fatigue or stress to phlebotomist's hand.
Existing solutions to the issues noted above include those described in U.S. Pat. Nos. 7,498,477, 8,481,803, and 8,524,974 all directed to a HEMOSTATIC DEVICE. The devices described in those patents employ a flexible band which wraps around the patient's wrist and is then secured. A syringe is employed to inflate an air bladder which presses against the puncture site.
In use of the device described in the patents, prior to fully removing the needle, catheter or other device that is inserted into the artery, the hemostatic device is put into place on the patient's wrist such that the air bladder is positioned over the puncture site and the patient's wrist is lifted to allow the band to be wrapped around the wrist. Assistance of a 2nd person may in some cases be required at the point of lifting the patient's wrist. The patient's wrist is then lowered again and the band is then secured to close the wrap around the wrist. A syringe filled with air is then attached to the inflation port on the band and air bladder is then inflated to a certain amount, for example, 10 to 18 ml, to apply pressure at the puncture site. The syringe is removed (the air bladder remains inflated by presence of a luer activated valve that maintains air in the bladder in absence of connection of the syringe via the luer lock) and the needle or catheter is then removed. If, as expected, no bleeding is observed, the syringe is re-attached, and a small amount of air is removed from the air bladder, for example, 1 ml. The puncture site is then observed for any bleeding. Air is continued to be removed in approximately 1 ml increments until bleeding is observed, whereupon about 1.5 to 2 ml of air is re-inserted into the bladder to stop the bleeding and achieve non-occlusive hemostatic. The syringe is removed and the band is left in place to allow the puncture site to heal against further bleeding. Every 5 to 15 minutes the syringe may be reattached and a small amount of air removed from the air bladder, to slowly relieve the pressure. A patient might wear the band for several hours in a typical use.
The interface for connection between the air port of the band and the syringe used for inflation and deflation is a tip portion of the syringe that fits into a receptacle attached to a supply tube feeding the air bladder on the band, and is a custom size/shape device, so it becomes important to not lose or damage the original syringe used for inflation when it comes time to deflate the air bladder, as it is then impossible to inflate or deflate the air bladder. If the original syringe is lost or damaged, a new band/syringe package must be opened to obtain a new syringe, leading to extra expense and waste of the unused band that was in the new package.
The use of a flexible band wrapped completely around the patient's arm can lead to tourniquet related issues since the band can be sufficiently tight as to stop or severely reduce blood flow beyond the band.